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Traumatic tension pneumothorax — RCPSC EM MCQ

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HardTraumaTraumatic tension pneumothoraxRCPSC EM

A 41-year-old cyclist is struck by a car. He is dyspnoeic, hypotensive and has distended neck veins. The left hemithorax is hyperresonant with absent breath sounds and trachea deviates to the right. Oxygen saturation is 84% on high-flow oxygen. What is the most appropriate next step?

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Correct answer: D — Perform immediate finger thoracostomy or needle decompression followed by chest tube placement

This is obstructive shock from traumatic tension pneumothorax. Decompression is a clinical intervention and must not wait for imaging when shock and classic findings are present.

Reference: ATLS; Canadian trauma systems guidance